| NPI | 1376842138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ID PA-1383) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA054823) |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2016-10-28 |