| NPI | 1508194374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 005896) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013732-1) |
| Enumeration Date | 2009-12-05 |
| Last Update Date | 2010-11-02 |