| NPI | 1144353327 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4361) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085001837) | 
| 363A00000X Physician Assistant (Licence: SC 2254) | |
| 363A00000X Physician Assistant (Licence: NC 0010-04861) | |
| Enumeration Date | 2007-03-14 | 
| Last Update Date | 2018-08-08 |