| NPI | 1407314552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2375) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56457) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2022-11-28 |