| NPI | 1407326382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003566A) |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2022-03-22 |