| NPI | 1396179560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8720) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2023-04-05 |