| NPI | 1508084849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08021) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C02991) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-01-31 |