| NPI | 1932262557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002263) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2014-12-02 |