| NPI | 1396336061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11954) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2025-08-09 |