| NPI | 1023556040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2095) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 086319) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2018-07-09 |