| NPI | 1942644521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1737) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NE 1737) |
| 363A00000X Physician Assistant (Licence: SD 1040) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2016-06-02 |