| NPI | 1023563038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005478) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2023-06-19 |