| NPI | 1508364340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008653) |
| 363A00000X Physician Assistant (Licence: GA 7697) | |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2024-04-25 |