| NPI | 1336184803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0286) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2016-11-15 |