| NPI | 1497193742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006836) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: GA 006836) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 006836) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2018-08-07 |