| NPI | 1922337591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054145) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA oa002408) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |