| NPI | 1861220063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 12595) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-10-11 |