| NPI | 1265722730 |
|---|---|
| Former Name | ISHITA THAKKAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056136) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014672) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2014-02-07 |