| NPI | 1629373790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054730) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002579) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |