| NPI | 1205132198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC TL 1618) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2019-11-01 |