| NPI | 1770714925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200601.RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1344) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2015-02-04 |