| NPI | 1972811438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4041) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2015-09-04 |