| NPI | 1972042653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3202) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2025-06-25 |