| NPI | 1720388184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 732) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105681) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2012-11-01 |