| NPI | 1396863874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005174) |
| 363A00000X Physician Assistant (Licence: MT 611) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-01-20 |