| NPI | 1992236889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1241) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA.9110292) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2018-03-17 |