| NPI | 1750358636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9853) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-09-09 |