NPI | 1063072601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10002719A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002719A) |
Enumeration Date | 2019-06-17 |
Last Update Date | 2023-12-04 |