| NPI | 1235314089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 1953) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2017-11-07 |