| NPI | 1316653538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5378) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009853) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2024-03-12 |