| NPI | 1750432142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 4813) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051675) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-12-22 |