| NPI | 1649390667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA522) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004738) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2009-06-30 |