| NPI | 1134229230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0003764) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 3724) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-11-29 |