| NPI | 1588801906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA0003479L) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2015-09-28 |