| NPI | 1548418965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200234.RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 04244) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2021-05-05 |