| NPI | 1235254368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA002909) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052352) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-09-23 |