| NPI | 1215484985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058364) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003852) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-01-03 |