| NPI | 1730307299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5877) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000844) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2010-08-30 |