| NPI | 1639129554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004152A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001907) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-03-29 |