| NPI | 1043617327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6527) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2224) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2023-11-28 |