| NPI | 1174683775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0002238) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10142002-1206) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-12-30 |