| NPI | 1689335101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-13205) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 10921) |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2023-05-19 |