| NPI | 1174908768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7719) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC PA2385) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-11-21 |