| NPI | 1811401318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-750) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PT2017-048) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2018-03-23 |