| NPI | 1598122707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2903) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7864) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2018-06-29 |