| NPI | 1992801450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA30109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C00002084) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |