| NPI | 1609496058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10039) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00766) |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2024-03-01 |