| NPI | 1467097956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00446) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3974) |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2020-12-30 |