| NPI | 1659322824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06345) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 0927) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2016-06-10 |