| NPI | 1093002461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5405) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2793) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2013-08-13 |