| NPI | 1225463144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 5596) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-04478) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2023-09-14 |