| NPI | 1164057881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10034) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2021-09-08 |