| NPI | 1811946379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002131) |
| 363A00000X Physician Assistant (Licence: DC PA030387) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2012-05-31 |