| NPI | 1689131005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1713) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2022-09-03 |