| NPI | 1477887685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03503) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 1088833) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA054080) | |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2020-10-25 |