| NPI | 1972638377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5161) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 4948) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-09-03 |