| NPI | 1306234836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003388) |
| 363A00000X Physician Assistant (Licence: PA MA057147) | |
| 363A00000X Physician Assistant (Licence: VA 0110-004791) | |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |