| NPI | 1033517131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2636) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7431) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2022-03-14 |