| NPI | 1306857990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5000478) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C50000478) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-09-12 |