| NPI | 1760451454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA-645) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2014-07-22 |