| NPI | 1225332463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SD 1005) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002172) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2015-11-17 |