| NPI | 1891306106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003232A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10904) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2021-09-01 |