| NPI | 1235159260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03037) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA051978) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2013-01-31 |