| NPI | 1598325631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009428) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004950A) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-08-21 |