| NPI | 1891090874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02828) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003500) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2013-11-12 |