| NPI | 1023467768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6640) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008000) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-11-10 |