| NPI | 1336440403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054728) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002577) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2017-08-22 |