| NPI | 1609811033 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001948) | 
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD C0001948) | 
| 207R00000X Internal Medicine (Licence: MD C0001948) | |
| Enumeration Date | 2006-06-19 | 
| Last Update Date | 2014-01-03 |