| NPI | 1396814752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 992) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC A992) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-11-28 |