| NPI | 1255903860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009845) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4525) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2025-12-09 |