| NPI | 1811330988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002901) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-09 |