| NPI | 1154354223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13224) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000001176) |
| 363A00000X Physician Assistant (Licence: CA 66852) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2025-08-26 |