| NPI | 1568990885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA9110326) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2023-08-09 |