| NPI | 1497174692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7141) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5627) |
| 363A00000X Physician Assistant (Licence: IN 10003002A) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-02-17 |