| NPI | 1871870535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0005392) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055205) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2017-04-10 |