| NPI | 1629492947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04793) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2018-08-06 |