| NPI | 1932310745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-396) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002488) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 1001380) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2011-03-09 |