| NPI | 1437760386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001010861) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 207Q00000X Family Medicine (Licence: NC 001010861) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2023-02-21 |