| NPI | 1477942290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200862) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 7398) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2016-10-31 |