| NPI | 1366826109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1175) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1926) |
| 363A00000X Physician Assistant (Licence: IA 0093943) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2019-10-18 |