| NPI | 1114348331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5592) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005162) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2016-02-16 |