| NPI | 1083047609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001784A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10001784A) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110004253) | |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2022-01-06 |