| NPI | 1467438465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1846) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 772-023) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2013-07-05 |