| NPI | 1366493108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: WI 41) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1671) |
| 367H00000X Anesthesiologist Assistant (Licence: MO 2014032535) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2018-08-28 |