| NPI | 1265434906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1344) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 3121) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2011-10-17 |