| NPI | 1336124239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV 1123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1789) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2011-11-23 |