| NPI | 1649523879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001832A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1775) |
| 363A00000X Physician Assistant (Licence: NC 0010-06842) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2021-03-24 |