| NPI | 1467701474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.848) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL TA-1749) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2019-06-03 |