| NPI | 1962733626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1994) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2019-11-06 |