| NPI | 1497049639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02922) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006847) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2013-08-07 |