| NPI | 1124008016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5698) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118389) |
| 363AM0700X Physician Assistant Medical (Licence: MN 9530) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-10-10 |