| NPI | 1235266180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2008031590) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY MY1549522) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-12-01 |