| NPI | 1851481725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA03176) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 85002846) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-09-08 |