| NPI | 1639886708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003788A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601011393) |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2024-09-03 |