| NPI | 1508811894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 002287) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 1469) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-02-08 |