| NPI | 1497961403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 000104155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 000104155) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 000104155) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2011-10-27 |