| NPI | 1487906814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064678) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2024-12-30 |