| NPI | 1639505225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001584A) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2023-01-09 |