| NPI | 1083393078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5373) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5660) |
| 363A00000X Physician Assistant (Licence: NC 0010-13309) | |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2024-07-30 |