| NPI | 1730500869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1115674) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2023-11-02 |