| NPI | 1053657015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109666) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2016-08-09 |