| NPI | 1518515766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7223) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2022-11-14 |