| NPI | 1548381965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC 99) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004727) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2012-04-30 |