| NPI | 1952865453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4190) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TN 4190) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2023-10-13 |