| NPI | 1952324576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA1614) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1614) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-08-10 |