| NPI | 1245575026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016213) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2025-03-07 |