| NPI | 1689021651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 008652) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06635) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2018-03-23 |