| NPI | 1386702652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01483) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2011-12-27 |