| NPI | 1356727564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2821) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0100-005064) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2022-12-02 |