| NPI | 1811498835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 129914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 129914) |
| Enumeration Date | 2018-02-25 |
| Last Update Date | 2018-06-11 |