| NPI | 1558810036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.303789) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2020-04-20 |