| NPI | 1992180418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4036) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-08-14 |