| NPI | 1447290911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD c0003683) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052100) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-03-11 |