| NPI | 1467767350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003358) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004265) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-16 |