| NPI | 1174171722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 191288) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 12247) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2024-04-25 |