| NPI | 1598647786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13221) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9120481) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |