| NPI | 1114234713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4709) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51376) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2019-02-28 |