| NPI | 1215547237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4189) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 4189) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110007278) | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2021-04-08 |