| NPI | 1578923504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3361) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 3361) |
| 363AM0700X Physician Assistant, Medical (Licence: TN 2991) | |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2024-08-23 |