| NPI | 1184051294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056529) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003169) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2015-12-23 |