| NPI | 1669459954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA051517) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002811) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2018-09-13 |