| 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 |