| NPI | 1306396700 |
|---|---|
| Former Name | PRUTHA PANCHAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008524) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53876) |
| 363A00000X Physician Assistant (Licence: IN 10004020A) | |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2025-06-05 |