| NPI | 1578963179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002926A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 02657) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2021-09-20 |