| NPI | 1053620930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004288A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003920) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2024-09-03 |