| NPI | 1962016717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008561) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2023-06-26 |