| NPI | 1689011538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057587) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001492A) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2020-12-21 |