| NPI | 1134456577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1787) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TN 1787) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2022-06-02 |