| NPI | 1386832681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001001368) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 470) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2008-08-29 |