| NPI | 1700369832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3786) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2022-05-05 |