| NPI | 1720365331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001355A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 363A00000X) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2023-10-19 |