| NPI | 1922416882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: WI 90) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: NM AA2014-003) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2017-03-15 |