| NPI | 1467601732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053713) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA 1084218) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2014-06-10 |