| NPI | 1255812129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007328) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002506A) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2025-03-26 |