| NPI | 1134292964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA172252) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-08-09 |