| NPI | 1356693022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99054153A) |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 5051) | |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2022-06-09 |