| NPI | 1821714908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11204) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 11204) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |