| NPI | 1437438926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4564) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054971) |
| 363A00000X Physician Assistant (Licence: NC 001006604) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2023-04-03 |