| NPI | 1225476492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006833) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 006833) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2023-02-02 |