| NPI | 1508288036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 007098) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 2558) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2022-01-10 |