| NPI | 1124326475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 2213) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 653) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2013-06-10 |