| NPI | 1174582290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4453) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010718) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2011-12-28 |