| NPI | 1477643088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0004046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 6033775-1206) |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA030646) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 009695) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-01-08 |