| NPI | 1932239902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0587) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001716) |
| 363A00000X Physician Assistant (Licence: MN 10526) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2010-08-17 |