| NPI | 1598481087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063732) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2024-06-05 |