| NPI | 1114391000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6982) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA10269) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2019-05-15 |