| NPI | 1215068549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1293) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-11-19 |