| NPI | 1407865934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 103329) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-09-04 |