| NPI | 1841788734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9773) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07988) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2020-08-19 |