| NPI | 1376195677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111917) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-10-18 |