| NPI | 1588936306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2541) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL TA.1741) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2024-04-03 |