| NPI | 1689850455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV CS20173) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2016-05-02 |