| NPI | 1265139562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 13229640-1206) |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2023-12-12 |