| NPI | 1285932822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1582) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5742) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2020-12-28 |