| NPI | 1780008649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00201) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2015-10-27 |