| NPI | 1578712394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7944) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056975) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2021-01-05 |