| NPI | 1285693986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC AFP-228) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2019-08-22 |