| NPI | 1336463009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001006743) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005814) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2016-10-06 |