| NPI | 1205218914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008607) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001863A) |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10001863A) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2023-11-08 |