| NPI | 1528153863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1670) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 5102257-1206) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-11-04 |