| NPI | 1952045692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PENDING) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2023-06-21 |