| NPI | 1720209935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1307) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 5017) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-09-13 |