| NPI | 1831593003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5196) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2022-11-09 |