| NPI | 1497373963 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 363AM0700X) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN Pending) | 
| Enumeration Date | 2020-07-10 | 
| Last Update Date | 2020-11-04 |