| NPI | 1770235855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10846) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4312) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-04-03 |