| NPI | 1356844385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12677) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2024-06-26 |