| NPI | 1770323305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12418) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 0000) |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-07-01 |