| NPI | 1740321371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003472) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2021-05-24 |