| NPI | 1740875251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5509) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8732) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2024-08-14 |