| NPI | 1215181847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1374) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3298) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2011-10-04 |