| NPI | 1790168284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6638) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2020-08-17 |