| NPI | 1922422583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00229) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2469) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2016-12-10 |