| NPI | 1093967648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030559) |
| 363A00000X Physician Assistant (Licence: MD C04191) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2011-09-14 |