| NPI | 1376272831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118290) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063595) |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-02-07 |