| NPI | 1811212392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2044) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 5745) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2015-07-14 |