| NPI | 1700537461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003564A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-008284) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2023-08-22 |