| NPI | 1467724401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C04684) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2016-07-28 |