| NPI | 1972586485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000665A) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-09-10 |