| NPI | 1992943872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0003944) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002849) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2012-11-05 |