| NPI | 1902231095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 006964) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC PA2149) |
| Enumeration Date | 2013-09-07 |
| Last Update Date | 2024-03-28 |