| NPI | 1548538739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003091) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000798) |
| 363A00000X Physician Assistant (Licence: PA MA055294) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2014-04-18 |