| NPI | 1497065429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003418) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05670) |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2022-04-08 |