| NPI | 1518360973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA1494) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA2812) |
| 363A00000X Physician Assistant (Licence: FL TPPA773) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2024-08-26 |