| NPI | 1538393806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053838) |
| 363A00000X Physician Assistant (Licence: MD C0004819) | |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2012-09-05 |