| NPI | 1881688257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001617) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01617) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2017-01-11 |