| NPI | 1831288752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 102620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 102620) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2009-03-19 |