| NPI | 1720058332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 000713PA) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 000713) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2009-09-23 |