NPI | 1073892212 |
---|---|
Former Name | AMI DILIP TRIVEDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19824) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002867) |
363A00000X Physician Assistant (Licence: NY 011008) | |
Enumeration Date | 2011-08-05 |
Last Update Date | 2021-12-14 |