| NPI | 1174861090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001662A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-004592) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2015-11-06 |