| NPI | 1609402882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4180) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113099) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2022-03-21 |