| NPI | 1477972958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2095) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2015-08-17 |