| NPI | 1295582815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10004826A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL TPPA660) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 10520) | |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2026-04-15 |