| NPI | 1487662615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA224) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9101111) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-01-16 |