| NPI | 1063719227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1485) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: LA PA.200430) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2020-09-25 |