| NPI | 1952889800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 04547) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 04547) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2022-03-29 |