| NPI | 1437154093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06357) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051750) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2017-07-17 |