| NPI | 1548347024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1027) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3536) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-09-14 |