| NPI | 1093955353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053790) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002342) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2013-08-05 |