| NPI | 1598160699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 100011755A)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 10001755A)  | 
| Enumeration Date | 2014-10-31 | 
| Last Update Date | 2021-09-02 |