| NPI | 1912319781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 007062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7062) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2019-05-16 |