| NPI | 1578680823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056328) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003463) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2013-11-19 |