| NPI | 1508993833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001718) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002771) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-05-25 |