| NPI | 1144658014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5562) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2018-08-23 |