| NPI | 1497080071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL1462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030694) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2010-12-16 |