| NPI | 1083659189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0110005279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005279) |
| 363A00000X Physician Assistant (Licence: MA PA3744) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-03-17 |