| NPI | 1750489597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 002740) |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 3188) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-10-16 |