| NPI | 1386895795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA055366) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2018-11-12 |