| NPI | 1811399249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7379) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4517) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2022-01-27 |