| NPI | 1083814537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000965A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA656) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2023-08-16 |