| NPI | 1235129974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051676) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MD051676) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2010-03-02 |