| NPI | 1275885071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200555) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA PA 200555) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2014-03-05 |