| NPI | 1619616737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003738A) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IN 1190648) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2022-11-09 |