| NPI | 1184881583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004872) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000562) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2018-06-06 |