| NPI | 1467889188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1253) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002448) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2021-08-10 |