| NPI | 1316341142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 2358) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AK 2358) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2021-02-05 |