| NPI | 1891967758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 7103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1515) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2023-02-07 |