| NPI | 1255392908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001880L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA000939) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-11-02 |