| NPI | 1770031239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3611) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2023-01-10 |