NPI | 1114627783 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003939A) |
Enumeration Date | 2023-03-03 |
Last Update Date | 2025-02-24 |