| NPI | 1891067534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002260) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2020-12-30 |