| NPI | 1023346236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003201) |
| Enumeration Date | 2009-11-28 |
| Last Update Date | 2018-07-06 |