| NPI | 1265686950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001965) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-11-08 |
| Last Update Date | 2010-09-08 |