| NPI | 1891995296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 3636) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 010832) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2016-04-14 |