| NPI | 1972033447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA M059048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004153) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |