| NPI | 1134377278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3627-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001018A) |
| 363A00000X Physician Assistant (Licence: TN 1916) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2015-08-18 |