| NPI | 1902907678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002615L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA RN187628L) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2015-03-13 |