| NPI | 1629213871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003037A) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2020-08-28 |