| NPI | 1790270833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002721A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7123) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2021-03-31 |