| NPI | 1235420175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.923) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1092166) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2014-04-22 |