| NPI | 1144689340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA ma062249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1667) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2022-01-25 |