| NPI | 1811029572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002212A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE INACTIVE) |
| 363A00000X Physician Assistant (Licence: TX PAO3379) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2023-11-03 |