| NPI | 1194190587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 008483) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006584-1) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2018-06-13 |