| NPI | 1659342772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 100863) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA C00001967) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2008-06-26 |