| NPI | 1609470830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 327712) |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2025-06-06 |