| NPI | 1245276948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001535) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2015-06-08 |