| NPI | 1891068631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10001395A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA 814) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2014-09-10 |