| NPI | 1982734117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 004305) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 2679) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2023-06-28 |