| NPI | 1366135410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006523) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064624) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2024-11-22 |