| NPI | 1932503596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ID PA-1365) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 5753) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2016-07-21 |