| NPI | 1245667401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C50000907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005197) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |