| NPI | 1548785785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10873) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4151-23) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2022-04-18 |