| NPI | 1114253739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054159) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2014-11-10 |