| NPI | 1417314303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019413-1) |
| 363A00000X Physician Assistant (Licence: SC 3031) | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2020-05-29 |