| NPI | 1861440323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2394) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-08-01 |