| NPI | 1639598105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-004560) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2024-05-20 |