| NPI | 1952530586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004763) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA TMA052087) |
| 363A00000X Physician Assistant (Licence: MD c00321) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2012-09-18 |