| NPI | 1114156031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004005) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2011-09-16 |