| NPI | 1548886641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3594) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 3594) | |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2024-07-08 |