| NPI | 1144575499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA3207) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6498) |
| 208D00000X General Practice (Licence: FL PA9109200) | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2024-02-28 |