| NPI | 1356886519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004038) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |