| NPI | 1831117068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103632) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND 103632) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-05-11 |