| NPI | 1811013741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00333) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: SC 724) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-11-30 |