| NPI | 1184921314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 1163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2315) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2018-04-23 |