| NPI | 1467819714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006024) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005159) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2016-01-18 |