| NPI | 1275905572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 300319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA1079) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2016-02-19 |