| NPI | 1982296604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007751) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2023-02-20 |