| NPI | 1114549193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2021046323) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-08-25 |