| NPI | 1366810384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200881) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2022-01-04 |