| 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 |