| NPI | 1215472410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 008230) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2018-07-10 |