| NPI | 1760030191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1191877) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2022-03-15 |