| NPI | 1184969073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004125) |
| 363A00000X Physician Assistant (Licence: IL 085006289) | |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2022-02-02 |