| NPI | 1467143669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6114) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601013280) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2026-01-16 |