| NPI | 1679195010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 5126) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MS 668) |
| 363AM0700X Physician Assistant Medical (Licence: TN 5126) | |
| 363AS0400X Physician Assistant Surgical (Licence: MS 668) | |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2022-12-16 |