| NPI | 1083154470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 996162) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA189595) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2024-09-10 |