| NPI | 1700172897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003971) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004690) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2012-12-21 |