| NPI | 1326682576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC MPA.5161) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11435) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2024-03-07 |