| NPI | 1144412883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006803) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01000) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2013-05-10 |