| NPI | 1013378413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C6041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06041) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2020-09-30 |