| NPI | 1871912915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA2273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2324) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-07-14 |