| NPI | 1114935152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000315) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA002115L) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-02-29 |