| NPI | 1770215071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 1000298A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY tc122) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2024-04-02 |