| NPI | 1710387121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001828A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11421) |
| 363A00000X Physician Assistant (Licence: OH 004085) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2022-11-30 |