| NPI | 1891981254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MP 67) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GU 42) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2011-01-26 |