| NPI | 1619367109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007499) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2018-08-30 |