NPI | 1679051536 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5511) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1149) |
363A00000X Physician Assistant (Licence: IA 092569) | |
Enumeration Date | 2018-08-02 |
Last Update Date | 2025-03-31 |