| NPI | 1336272822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA000814) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA050823) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2009-03-05 |