| NPI | 1033525282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057499) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3351-23) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2015-10-09 |