| NPI | 1497172555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181966) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-09-22 |