| NPI | 1841206836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 107) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02286) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-12-16 |