| NPI | 1336453992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 182673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5386) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2022-06-07 |