| NPI | 1245217306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA00539) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00539) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2009-04-13 |