| NPI | 1619108206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA PA 2660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 280) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2018-10-05 |