| NPI | 1639329717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06644) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00108) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2016-12-06 |