| NPI | 1841611357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 2467) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110005045) |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2024-02-29 |