| NPI | 1841057510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1371) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012058) |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-12-30 |