| NPI | 1760260798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5750) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-11-21 |