| NPI | 1053738864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 2090) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 12363) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2016-09-13 |