| NPI | 1932615135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9412) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07841) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2021-04-22 |