| NPI | 1497701239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC A649) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-12-31 |