| NPI | 1528381522 |
|---|---|
| Former Name | PUNAM JAVIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 005792) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 0010-04357) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 5792) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2022-10-11 |