| NPI | 1992936264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054433) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002383) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2010-07-26 |