| NPI | 1942807417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9967) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 324418) |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2024-06-25 |