| NPI | 1033589080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7774) |
| Enumeration Date | 2015-10-03 |
| Last Update Date | 2019-03-25 |