| NPI | 1861631764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL 1142) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1703) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2021-10-25 |