| NPI | 1285032748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004818) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2022-12-01 |