| NPI | 1619638897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10693) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4248) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2024-02-27 |