| NPI | 1265049340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 174400000X Specialist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2024-01-05 |