| NPI | 1811227903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056860) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003209) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2014-06-11 |