| NPI | 1457781148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IA 082332) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 5589) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2017-05-04 |