| NPI | 1396055471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DC PA30037) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110840738) |
| 363AM0700X Physician Assistant Medical (Licence: MD C0003131) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2010-10-07 |