| NPI | 1972033074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8359) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008359) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2020-12-09 |