| NPI | 1982617387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000858A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105820) |
| 363A00000X Physician Assistant (Licence: KY PA1182) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-12-28 |