| NPI | 1932677549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1448) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002622A) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10002622A) | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2019-08-28 |