| NPI | 1922466135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 008791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06250) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2018-11-27 |