| NPI | 1932358918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0003751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002883) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2012-10-30 |