| NPI | 1831205665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AK PADA685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 685) |
| 363A00000X Physician Assistant (Licence: AK 1652) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-11-08 |