| NPI | 1538192356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003014) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-01-30 |