| NPI | 1467858373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00231) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2015-02-06 |