| NPI | 1831287259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 41199) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ND pac0356) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-07-27 |