| NPI | 1770914327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 6965) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 006965) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2015-04-07 |