| NPI | 1083109102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9231) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006251) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2024-05-06 |