| NPI | 1063956431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 8429) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2019-03-05 |