| NPI | 1023662046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4375) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2019020855) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2022-03-31 |