| NPI | 1194180083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058037) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2025-04-21 |