| NPI | 1245567775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200296) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2020-05-06 |