| NPI | 1760527253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 903) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2019-11-06 |