| NPI | 1679832588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52584) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2022-03-29 |