| NPI | 1043622277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2015009297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001633A) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2015-11-03 |