| NPI | 1508137217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 1076) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 363A00000X Physician Assistant (Licence: AK 2224) | |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2021-02-24 |