| NPI | 1437762564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006323) |
| 363A00000X Physician Assistant (Licence: TX PA13783) | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-02-24 |