| NPI | 1497265573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA004277) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059359) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-04-16 |