| NPI | 1831550003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA1252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2985) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2018-03-17 |