| NPI | 1467490276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01941) |
| 363A00000X Physician Assistant (Licence: PA MA051606) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2017-03-20 |