| NPI | 1679607352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001002058) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2010-02-26 |