| NPI | 1851871313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6724) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2020-12-02 |