| NPI | 1831796762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 71010519A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28160460A) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2024-12-13 |