| NPI | 1235401852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 077003) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2015-05-28 |