| NPI | 1962166504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4772) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10698) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2024-11-07 |