| NPI | 1811998628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00597) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2016-02-09 |