| NPI | 1194158147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2780) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006884) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2021-04-27 |