| NPI | 1912570748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5692) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA-2048) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2025-04-19 |