| NPI | 1316367204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 4817) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8982) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 8982) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2022-11-09 |