| NPI | 1609160142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 006017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006017) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2021-03-31 |