| NPI | 1295734069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001366) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000381) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2015-12-08 |