| NPI | 1730828468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 5106) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2024-11-11 |