| NPI | 1528302833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ID PA-1608) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MAO55875) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2019-01-24 |