| NPI | 1477986552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056924) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2016-06-16 |