| NPI | 1932298429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 0454) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4054) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 006236) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-12-12 |