| NPI | 1255192555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5909) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-09-16 |