| NPI | 1720756554 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003444A) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2021-09-06 | 
| Last Update Date | 2024-05-17 |