| NPI | 1982033395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1911) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60491889) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2021-11-18 |