| NPI | 1457718892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA-1113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL TA.1816) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-09-09 |