| NPI | 1881676757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 000749) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 00749) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2015-06-29 |