| NPI | 1548853211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004709B) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026338) |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2025-05-09 |