| NPI | 1396142097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003454) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057261) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2015-01-05 |