| NPI | 1174600688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 1001044A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00559) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-01-06 |