| NPI | 1215244496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6334) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 011000562) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2016-08-26 |