| NPI | 1457822363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08454) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2023-11-30 |