| NPI | 1144281064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-003716) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2013-08-13 |