| NPI | 1073031233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1107) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2019-07-05 |