| NPI | 1881745081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA662) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1018) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2017-01-23 |