| NPI | 1457338766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2030) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 1398) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2016-03-16 |