| NPI | 1083885610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 001001297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01297) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2017-03-20 |