| NPI | 1629796768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13888) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5077) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2026-07-01 |