| NPI | 1457782369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056655) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |