| NPI | 1790769008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05161) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001429A) |
| 363A00000X Physician Assistant (Licence: PA MA053807) | |
| 363A00000X Physician Assistant (Licence: CA 56513) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-01-24 |