| NPI | 1255397378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2792) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 2792) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-06-18 |