| NPI | 1306949813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0002673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001668) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2008-04-11 |