| NPI | 1013431733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IN 10002646B) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006321) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2019-11-15 |