| NPI | 1306862123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS PA032) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA274) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-05-27 |