| NPI | 1841566684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 1053) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03298) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2014-01-31 |