| NPI | 1346574787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4436) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 604) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2021-12-21 |