| NPI | 1255888970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2607) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8088) |
| Enumeration Date | 2016-09-10 |
| Last Update Date | 2018-11-28 |