| NPI | 1851560049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SD 0738) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 001888) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2012-08-21 |