| NPI | 1326475674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05973) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004779) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2016-02-24 |