| NPI | 1891998753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1732) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 1070) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2015-01-15 |