| NPI | 1225033566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 537) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2009-02-04 |