| NPI | 1457547499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA9100055) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9100055) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2017-02-14 |