| NPI | 1366193971 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003558A) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2022-01-14 | 
| Last Update Date | 2022-04-12 |