| NPI | 1235383639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001245A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002195) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2012-11-16 |