| NPI | 1295877256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0000699) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U02416) | 
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2022-07-21 |