| NPI | 1699140954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002545A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC447) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2022-06-27 |