| NPI | 1285252015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C08383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD C08383) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2024-03-07 |