| NPI | 1265499552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052512) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2016-02-01 |