| NPI | 1508442732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9114073) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2023-07-11 |