| NPI | 1639699853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10986) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005800) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-12-21 |