| NPI | 1295750685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA TMA051468) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-05-22 |