| NPI | 1134401326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1091) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 8075898-1206) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2022-12-30 |