| NPI | 1477018455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10301) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6945) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-03-21 |