| NPI | 1437585007 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056355)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003115)  | 
| Enumeration Date | 2013-09-16 | 
| Last Update Date | 2014-06-27 |