| NPI | 1053922880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2137) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 1189253) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2023-08-22 |