| NPI | 1053344044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3442) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-11-20 |