| NPI | 1972583904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 2598) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003860) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2010-12-07 |