| NPI | 1396841516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6158) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 001156-1) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA02234) | |
| 363AM0700X Physician Assistant, Medical (Licence: OH 1983) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2018-06-29 |