| NPI | 1366593881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02244) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010573) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-07-15 |