| NPI | 1992103477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003507A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: IL 085.005306) | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2023-08-30 |