| NPI | 1538147756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6029) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001053) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-01-19 |