| NPI | 1164891990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1347) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108828) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2021-02-18 |