| NPI | 1700395266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 5010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9110767) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-12-28 |