| NPI | 1396884219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00392) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 100392) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2014-04-23 |