| NPI | 1902214521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 127956) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1836) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2018-03-17 |