| NPI | 1255400404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C002041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002041) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2016-04-29 |