| NPI | 1518472927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 008671) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WI 4983) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2022-10-17 |