| NPI | 1497985139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02583) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003059) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 011003059) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02583) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2014-10-21 |