| NPI | 1588396378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00746) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5678) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2024-03-19 |