| NPI | 1740259803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA000916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051479) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |