| NPI | 1144867946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061314) |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2021-10-01 |