| NPI | 1902371149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111500) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-02-21 |