| NPI | 1275759292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001957) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2010-07-28 |