| NPI | 1043805096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3812) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003141A) |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2021-12-17 |