| NPI | 1275761579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 99068005A) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA053869) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA-053869) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2015-07-08 |