| NPI | 1033750245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061141) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-10-14 |