| NPI | 1902994999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002920A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004907) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2024-07-02 |