| NPI | 1902980246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA GA4447) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1519) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-05-24 |