| NPI | 1497816375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 002374) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00607) |
| 363AM0700X Physician Assistant, Medical (Licence: SC a472) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA10004665) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2009-06-25 |