| NPI | 1447262308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2006012204) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1501117) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2014-07-29 |