| NPI | 1386985786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 6034) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 16464) |
| Enumeration Date | 2013-03-09 |
| Last Update Date | 2017-03-14 |