| NPI | 1245472786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001140A) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2020-12-30 |