| NPI | 1366717340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL PA9106453) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2019-06-25 |