| NPI | 1417121427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01635) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1926) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2019-11-18 |