| NPI | 1295791788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1433) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2009-05-20 |