| NPI | 1447587514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002415) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054019) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2011-09-09 |