| NPI | 1417135054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01314) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2016-09-23 |