| NPI | 1811910912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 076377) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-03-19 |