| NPI | 1710246731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.1506) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106559) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-06-28 |