| NPI | 1861432163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 159703) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004679) |
| 363A00000X Physician Assistant (Licence: NM 2010-0006) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-05-21 |