| NPI | 1770079774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10002529A)  | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| 363AM0700X Physician Assistant, Medical (Licence: OK 4789)  | |
| Enumeration Date | 2018-07-03 | 
| Last Update Date | 2025-01-17 |