| NPI | 1295088656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4670) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: LA PA.200557) | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2022-04-08 |