| NPI | 1407811995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 000656) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 511) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-08-26 |