| NPI | 1457730574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065094) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2025-02-11 |