| NPI | 1225037971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 3998) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 708) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2015-11-24 |