| NPI | 1205210861 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002344A) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005550) | 
| Enumeration Date | 2015-07-14 | 
| Last Update Date | 2024-07-04 |