| NPI | 1124291364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002699) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA A23905482) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-10-16 |