| NPI | 1548935984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11422) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2024-01-16 |