| NPI | 1982636502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0001337) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R092205) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-04-05 |