| NPI | 1538431200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6369) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13847) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2024-05-20 |