| NPI | 1639786999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003766A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX 1175928) |
| 363AM0700X Physician Assistant Medical (Licence: IN 10003766A) | |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2022-09-21 |