| NPI | 1023477536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL3012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2955) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2020-12-31 |