| NPI | 1235182254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0468) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 000871) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-07-12 |