| NPI | 1225091358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 1766) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1766) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2012-03-06 |