| NPI | 1235488289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1564) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108355) |
| 363A00000X Physician Assistant (Licence: PA TMA052689) | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2020-08-28 |