| NPI | 1104530567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10005004A) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2025-09-12 |