| NPI | 1093071706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6356) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2015-01-12 |