| NPI | 1841808243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 9859) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1173225) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2021-01-07 |