| NPI | 1770952236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002357A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.05626) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2021-03-17 |