| NPI | 1649448952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058155) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C50000325) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2016-09-15 |