| NPI | 1063669521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200871) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200871) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2019-02-21 |