| NPI | 1316262173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054250) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2018-04-19 |