| NPI | 1588290787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4962) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001405) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2022-11-09 |