| NPI | 1083910301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11434) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02750) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2023-03-20 |