| NPI | 1992348254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008535) |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2024-10-21 |