| NPI | 1982971719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004072) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001346A) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2014-02-03 |