| NPI | 1720463532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002254A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC391) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2019-12-30 |