| NPI | 1457790107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6848) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05148) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2022-05-05 |