| NPI | 1952957052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9409) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: GA 9409) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2021-03-12 |