| NPI | 1255597993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA A10236RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003216) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2010-01-05 |