| NPI | 1356359707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1179-023) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2008-08-06 |