| NPI | 1659314367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 8) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0008) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-06-29 |