| NPI | 1487259693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 98) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 876) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2020-12-10 |