| NPI | 1881084994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1478) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-004848) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2017-03-10 |