| NPI | 1366628315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2169) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001359A) |
| Enumeration Date | 2008-01-20 |
| Last Update Date | 2018-07-02 |