| NPI | 1689965618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3199) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2024-07-10 |