| NPI | 1275181299 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003898A) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56961) | 
| Enumeration Date | 2019-09-03 | 
| Last Update Date | 2024-09-11 |