| NPI | 1982001509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2121) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2022-07-22 |