| NPI | 1841798550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9035) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS 00360) |
| Enumeration Date | 2018-01-28 |
| Last Update Date | 2022-09-13 |