| NPI | 1215456546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4923) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07592) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2024-06-11 |