| NPI | 1053046383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022013796) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-06-13 |