| NPI | 1942422415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA002103L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI amd440) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-07-30 |