| NPI | 1255775656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04048) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2019-11-15 |