| NPI | 1750970091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021004288) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003611A) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-08-10 |