| NPI | 1174835334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.712) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2022-04-07 |