| NPI | 1326358920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006004) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04221) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2021-12-30 |