| NPI | 1427079227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1913) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1501024) |
| 363A00000X Physician Assistant (Licence: CA 52043) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-05-12 |