| NPI | 1629553383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10810) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006922) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2025-07-25 |