| NPI | 1437677234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10530) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1307) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2021-10-27 |