| NPI | 1255343844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003480A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60516058) |
| 363A00000X Physician Assistant (Licence: MA 1754) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2022-01-31 |