| NPI | 1518305580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 1111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7475) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-03-23 |