| NPI | 1366675787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5719) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: SC PA2324) | |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2022-05-05 |