| NPI | 1083987804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1640) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: NE 2295) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2017-03-08 |