| NPI | 1821225194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003966) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2018-07-05 |