| NPI | 1568494037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01862) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0619) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-04-22 |