| NPI | 1407037674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-564) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2017-04-11 |