| NPI | 1396933065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003633) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2018-04-06 |