| NPI | 1982954897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000864) |
| 363A00000X Physician Assistant (Licence: PA MA057045) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2021-08-09 |