| NPI | 1942639307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10368) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9109212) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2021-07-12 |