| NPI | 1932110939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1572) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA150530) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-06-24 |