| NPI | 1295390391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 320841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PT2019-025) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2020-12-11 |