| NPI | 1457378085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001476A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003446) |
| 363A00000X Physician Assistant (Licence: IL 085-002189) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2017-02-28 |