| NPI | 1083876148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 1622) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA1622) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-07-02 |