| NPI | 1558054262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5541) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TN 5541) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2024-04-10 |