| NPI | 1386844322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA9101657) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9101657) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2025-03-06 |