| NPI | 1093002065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054946) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2019-11-06 |