| NPI | 1770237950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4972) |
| 363AM0700X Physician Assistant, Medical (Licence: TN 4972) | |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2023-10-20 |