| NPI | 1053995407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10355) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1177769) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2022-10-11 |