| NPI | 1821425869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5540) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2018-03-08 |