| NPI | 1245412576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 1545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1545) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2025-01-03 |