| NPI | 1306980933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001782A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-003028) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2021-03-22 |