| NPI | 1013244466 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9086) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2303) | 
| Enumeration Date | 2009-11-05 | 
| Last Update Date | 2022-05-06 |