| NPI | 1013232321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3257) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4612) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2019-12-10 |