| NPI | 1881148823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8048) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 8048) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |