| NPI | 1497763759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2034) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-06-02 |