| NPI | 1447481163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 157664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002269) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2014-02-27 |