| NPI | 1194208355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10638) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08264) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2022-10-21 |