| NPI | 1700270386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003634A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MI 5601008132) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-09-19 |