| NPI | 1386950202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056817) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical (Licence: IN 10001227) | |
| 363AS0400X Physician Assistant Surgical (Licence: PA MA056817) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2023-12-05 |