| NPI | 1740246420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05021) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C50000448) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2014-04-24 |