| NPI | 1740879428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4349) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007619) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2024-02-09 |