| NPI | 1285008276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 10937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6248) |
| Enumeration Date | 2015-11-14 |
| Last Update Date | 2018-06-22 |