| NPI | 1437175536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD PA61209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000690) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-05-05 |