| NPI | 1265511810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110454) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2010-11-09 |