| NPI | 1497770671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0100-04624) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110001596) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-02-25 |