| NPI | 1962757740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2529) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001421A) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2022-10-06 |