| NPI | 1558031047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 4615) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000004615) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2024-10-23 |