| NPI | 1447831680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 334785) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2023-04-19 |