| NPI | 1861865016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA2709) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7788) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2019-05-03 |