| NPI | 1639700925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9732) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112639) |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2023-08-18 |