| NPI | 1194781617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110 002181) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002516) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2012-11-01 |