| NPI | 1467528240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL 7384) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9102324) |
| Enumeration Date | 2006-11-26 |
| Last Update Date | 2010-08-04 |