| NPI | 1881851764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA030584) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 0007837) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2009-10-16 |