| NPI | 1881716009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME 513) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 834) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-10-03 |