| NPI | 1487301222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11137) |
| Additional Taxonomies | 261QX0200X Clinic/Center, Oncology (Licence: GA 11137) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 11137) | |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2024-01-24 |